How to Recover from an Injury: Hint…Don’t Try it Without a Movement Therapist (Part 2)


Is there an optimal way to heal and recover from injury? The short answer is YES. But what does that look like? Here is a great example in Part Two of How to Recover from an Injury by Heidi Armstrong of Injured Athlete’s Toolbox.


How to Recover from an Injury: Hint…Don’t Try it Without a Movement Therapist (Part 2)

Guest blog by Heidi Armstrong of The Injured Athlete’s Toolbox

How to Recover from an injury

This is the second in a 4-part series where I’ll share why, after injury, working with a Movement Therapist is a must. You can read part 1 here.

I’ll share what prompted me to see Jesse, what happens to your nervous system after an injury, and how Movement Therapy helps. I’ll also share how Jesse is helping me unlearn 5 years of constrained (or unnatural) movement.

No, Jesse isn’t paying me to write this. That’s not my style or his. My hope is that my experience will motivate you to recapture the movements that injury has greedily taken.

If you haven’t read part 1 of this series, read that first, then come back.

After years of injury recovery I knew I wasn’t moving with my former fluidity or balance. I just didn’t realize the depth of my brain’s dysfunctional rut until I saw Jesse. Since even minor injuries result in altered movement, I guess I shouldn’t have been surprised to discover how much of my normal mobility I had lost.

Normally, muscles are supposed to react and respond to movement, but when we’re injured, the body cannot get into the right space (because it’s lacking range of motion) for muscles to work properly. The result: we feel tightness followed by pain.

Despite lots of daily stretching, I felt my body getting more and more restricted on the side opposite of my injury, specifically my hip and back. I learned why from Jesse. Note: It’s very common for second injuries to happen on a part of the body diagonal from the first injury.

Jesse said, “Traditional static stretching isn’t great for movement restoration because it doesn’t challenge the nervous system in gravity. Static stretching has its place, but I consider it like salting your food. A little goes a long way.”

Click here to read more…

Week One Injury Update

medial-meniscus-over-compensation-pain Injury UpdateIt’s been a little over a week since I heard the big “pop” in my knee and damaged my meniscus. Here is my week one injury update.

I am in the process of getting an appointment with the orthopedic doctor. I had x-rays last Friday. You can’t see meniscus damage in an x-ray, but the Ortho docs won’t even see you until you’ve had them done. All they could see was swelling in the knee. I’m not in a huge hurry to see the docs. I’m more curious as to what type of tear I have. I won’t even consider surgery for 6-12 months, so if it takes a few weeks to get an appointment, I’m good with that.

I am grateful for the work I do for a living and to have the knowledge about physical therapy that I have. I know the protocol well. I have been actively engaged in keeping my body moving as well as possible over the past week beginning the day of the injury. The big challenge is to focus on exploring what I “can do” not the “can’t do’s”

Pain has been significant and pretty consistent. Some days worse than others. Yesterday was a good day. Today has been rough. It doesn’t so much hurt to move. It hurts more when I don’t move. Sitting is the worst. Up and down hills and stairs are tough because of pain. Hand foot crawls are impossible at the moment. I’m starting to get some compensation discomfort in my left calf and right side low back.

Week One Knee Injury Update:The Can Do’s:

Even though pain has been significant, I’ve seen some substantial improvement in knee function.
-I have 95+% range of motion of the knee, which bodes well for recovery. I can do a full deep assisted squat without pain. The primary range I don’t have is foot loaded tibial rotation.
-I’ve quickly gone from 10 minutes on the stationary bike at level 0 to 4 sets of 10 minutes at level 3. Hoping to get on a real bike in a week or so.
-I can now transition side to side shin box without my hands on the floor without pain. It took 4-5 days to get that function back.
-I can swim. Kicking feels good, although pushing off the wall can be painful. So I have to go super slow. It feels good to have some kind of movement I can focus on.
-climbing and floor work. Push-ups, pull ups, parallette bar work. Upper body is going to be beast by the end of this.


This is the toughest part of a big injury. Toughest to feel and definitely toughest to express. I find myself putting on the straight face with most people, including myself. But the reality is that I feel this injury even more emotionally than I do physically.

It sucks. Movement is a big part of my life. Feeling capable is where I feel strong. The first few days I was constantly seeing all the things I could not do. They started adding up. Emotionally, I was feeling hurt, sadness, uncertainty, and fear. Over the past few days, it’s been anger. I’m basically a big ball of swirling emotions.

This is the hardest part of getting injured. The last thing I want to do is to push these emotions down. I don’t want to suppress. I don’t want to hold onto it. I am willing to feel, even if feeling sometimes feels uncomfortable.

At the same time, I don’t want these feelings to rule my thoughts and choices. It’s easy to spin into a deep dark place and give up. Giving up will not help me heal. Giving up will not teach me about myself. Giving up will not put me in a better place on the other side of this injury. Giving up is not an option. Surrendering to the fact that I am an emotional human being going through a challenging experience; and allowing myself to be ok, is the only choice I see. I will cry when I feel tears come up and I will continue to step, or at times limp, forward.

I am grateful for this opportunity to learn something about myself. I look forward to the person I meet on the other side.

Injury! Setback or Opportunity

Injury! A setback or an opportunity?

It’s a very simple yet profound choice. Do you see an injury as a setback? Or can you find the opportunity it brings you? Which one you choose will play a major role in the type of progress you make during your recovery. I now get to make this choice once again for myself.

meniscus tear type - Injury setback opportunityA couple days ago, on Wednesday August 3rd,  I felt a pop in my knee (my good knee) standing out of a deep pistol squat position. This is a movement I’ve performed countless times. I was showing a client what a pistol squat was, but my body was not prepared properly to make it. All signs turn towards a torn meniscus. A significant injury.

Yes, it will be a setback to my workout program. It will probably take at least a year to recover from without surgery and even longer if I opt for surgery.

Is this Injury a Setback or Opportunity?

No! It is an opportunity. I get to learn something new about myself; about my body; and about injury, healing, and recovery.

I am reeling a bit emotionally. There is a level in which an injury just sucks. I’m sure I’ll get to explore the depths of emotions such as anger, disappointment, self judgement, and depression over the next few weeks and months. There is always a strong emotional component to injury. Which is why my choice of outlook is so important.

I am willing to feel the emotional rollercoaster that is coming because even in the depths of it, I will learn and grow.

Injury sucks, my movement progress will be setback, but I am grateful for the opportunity to learn about myself. I’ll keep you updated on my progress.

Do you know someone dealing with pain or injury? Please share this page with them.

2016 Summer Shoe Review

Shoes Matter

Free your feetIt’s summertime, and the thing I love about the summer is that I get to spend so much more time barefoot. As many of you know by now, I am an enthusiastic barefoot advocate. I believe that a barefoot lifestyle is important for health, wellness, and a lifetime of pain-free movement. Which is why I’m offering my summer shoe review for 2016.

Going barefoot is not without risk. There are times, based upon terrain or circumstance, when shoes are necessary. These circumstances may include the Hill Country’s unforgivingly rocky hiking trails combined with lurking thorns and thistles … and, of course, the need to walk into “No Shirt No Shoes No Service” businesses.

Funny thing: Prior to transitioning into a barefoot lifestyle, I basically owned two pairs of shoes — basketball shoes and non-basketball shoes. Over the past six-plus years that I have embraced a barefoot lifestyle (I am completely barefoot 90% of the time), my shoe wardrobe has greatly expanded.

Like tools, my shoes have taken on functional purposes. I have a tool for every job. I have trail sandals for most running, climbing, jumping, sprinting, and just overall challenging movement; casual sandals for comfortable wear, such as going to the grocery store; dressier shoes; cold weather wet shoes; cold weather dry shoes; and more. For someone who is barefoot as much as I am, I have quite the shoe collection!


images-2This time of year, most people reach for their trusted flip-flops. These are, in my opinion, one of the worst shoe choices you can make. The lack of a simple heel strap to keep the shoe attached to your foot means that with every step you take you must grip your toes just to keep the shoe on your foot. This creates an unnatural gait pattern.

For short durations, if you have no significant movement dysfunctions, this may not be a big deal. However, if you already have a history of poor gait mechanics (which most people do), wearing flip-flops for extended periods can create problems. This is especially true in the spring as you are transitioning away from heavy supportive winter boots or shoes which weaken the muscles of the foot. This not only can manifest in foot pain, but can also show up as knee, back, hip, and neck injuries.


Summer Shoe Review

In the interest of full disclosure, I am an affiliate for many of these products. This means that if you purchase one after clicking one of these links, I will get a small commission. That said, the only reason I am an affiliate for these products is because I believe in them 100%.

Luna Sandals

Luna Sandals - Summer Shoe ReviewI do most of my hiking and running on rocky Texas trails. I haven’t built my barefoot ability to be able to go through miles and miles of gnarly rocks and cactus. Nor do I feel it necessary to become that hardcore barefoot. I need something to protect my feet. When I do need to wear shoes, I want it to be the least amount of shoe possible. That is why I love Luna sandals.

The Luna sandals are my go-to for the trails. I own the Leadville model, and I love them because they are incredibly secure on my feet. The nylon strap on them is perfect for regular running, trail running, climbing, tracking, traversing. The last thing I want when I’m bounding through rocky terrain is for the shoe to slip and to lose traction between the shoe and myself. The strap doesn’t stretch or give, so I keep the shoe fairly tight on my foot. I wear these shoes 6-7 months a year for more extreme movement.

The downside of this sandal is that the strap and buckle system aren’t super comfortable. They bite into the top of my foot a bit, not something I want in casual footwear for restaurants and grocery stores where shoes are required. In addition, I am not a fan of their Monkey Grip Technology (MGT) footbed. The MGT took a long time to break in and creates hot spots under my feet. I prefer the leather footbed option.

Earth Runner Sandals

Earthrunner Sandals - Summer Shoe ReviewEarth Runners Sandals are my go-to for everything else. These are plush comfortable sandals, and the soft leather strap and buckle system feels super comfy on my foot. They also look nice, so you can get away with wearing them to casual events. I get tons of compliments on these sandals. When you need a shoe that looks good, feels good, and is comfortable, these are great sandals.

Overall, I don’t have any major complaints when it comes to these shoes. I did find that the super thin sole took a very long time to break in. Since I don’t wear shoes much, it took even longer. With daily wear, I’d expect it to take between 2-4 weeks to fully break these shoes in.

Also these sandals are exclusively casual wear for me. Because the leather has a “stretch” to it, I don’t wear them for outdoor activities. If I’m running, climbing, or jumping, the sole has a tendency to slide out from under my foot. I need the sole to remain solid under my foot.

Earth Runners also make children’s sandals, custom-made based on a tracing of your child’s foot.


Even in Austin, you occasionally need a full shoe for more formal occasions.

Soft Star Shoes - Summer Shoe ReviewSoft Star Shoes

I have the Soft Star Shoes Rogue model, and I love them. They have a Vibram TM rubber sole, and a sheepskin-lined footbed. Basically a moccasin style shoe, these are easy to slip on and off, and they keep my feet warm for chilly Texas winters and relatively dry when it’s wet. They’re not super fancy or stylish; they are just nice comfortable shoes.

These are also incredible for kids. Early walkers need shoes on their feet to keep them warm (and of course, shoes are required for school), but you especially want children to really feel the ground and interact with it as they’re learning. If a shoe interferes with your child’s development as they learn how to walk, the effects will last into adulthood.

Vivobarefoot Shoes

Vivobarefoot shoes - Summer Shoe ReviewI have several different pairs of Vivobarefoot shoes, and my son has their rainboots and daily wear shoes. These are really comfortable shoes, and they carry a number of styles, from more casual to dressier shoes. These are shoes you can really live in. I have their running, casual, and dress shoes. Honestly, the only downside is that they are pretty pricey. But they do hold up well and give you the options you need.

Do you have a barefoot/minimalist style summer shoe review that you love. I’d love to hear about it. Please share and tag me through social media.

A Year of Moving Better

This is a guest post from Kimberly Culbertson, who just celebrated her one year moving better anniversary with The Art of Fitness!! 

Just a little red in the face after our moving better workout this morning!
Just a little red in the face after our workout this morning!

Today marks a full year of movement therapy with Jesse! I wasn’t sure what I was getting into when I began the journey, but I’m glad I did 🙂

I wasn’t exactly in the market for a new movement paradigm, but I overheard Jesse talking with a colleague at Orange Coworking, and I was curious enough to brave a conversation with a scary personal trainer. (Okay it turns out he’s not really scary at all. Quirky, maybe.)

The truth is that I’m not “the athletic type,” although, as I type that, I can almost hear Jesse sternly begin a little speech about how every human is meant for movement. After surviving middle school gym class, I had mostly kept my distance from fit people, and to a certain degree, from movement in general. I’ve been gifted in more intellectual pursuits, and movement in the physical world has always been a secondary activity, a necessary evil.

My whole life is marked by seasons of dieting and various spurts of exercise, but it wasn’t until my late 20’s that I started to see fitness and strength as markers of self-care and even self-love. Despite genuine effort though, I consistently began some workout program, injured myself within a couple of months, and then had long seasons of pain and recovery. I had bad knees, a reverse curve in my neck, foot pain, messed up shoulders, and a long line of people ready to tell me that losing weight was the only real solution. But losing weight requires exercise and exercise causes injury, so pursuing weight loss turned me into a depressed, she’s-a-little-bit-crazy person. And that person was in pain.

To make matters worse, about two years ago I injured my shoulder. It was some kind of swollen, tight, pinched nerve mess in my right shoulder blade, and it didn’t go away after a couple of weeks. The pain was severe and made it nearly impossible to lift my arms while seated. I know that’s very specific, but this was a big problem for driving and typing (and since I was working as a freelance writer, typing was pretty important). With pain meds and chiropractic and electro stim therapy andrest and ice, the pain lessened to about a 4 on a ten-point scale, a big improvement from the original 9-intensity, but still noticeable, chronic pain. After a year, I figured this pain was probably mine to keep.

Enter Jesse, The “Movement Therapy” Coach.

Jesse is actually part monkey. He gives occasional speeches about why you too should be able to climb a tree :)
Jesse is actually part monkey. He gives occasional speeches about why you too should be able to climb a tree 🙂

When I sat down with Jesse, my defenses were high. I had a speech ready, and it went something like this: “Look, I know I’m not thin, but I’m not trying to lose weight right now because I like my sanity. I don’t hate who I am, and I’m not trying to earn my right to exist by changing my shape. I do have a 4-year-old, though, and I want to be just as active as he wants to be. And I want to feel healthy. In the past, I’ve genuinely enjoyed working out, but I have an injury that causes me chronic pain, and at this point I’m a little bit afraid to move.”  

I didn’t know it yet, but Jesse’s movement therapy approach was exactly what I needed. His philosophy is that fitness should help a person increase function and enjoy movement, and that any external changes are a side effect. Extra pounds don’t disqualify someone from movement in his book, and really shouldn’t be the focus. This was a relief, since my first experience with a personal trainer was a free session with “Tank” (no, really) during which he told me to ride the seated bike until I lost 25 lbs, at which time he might consider working with me more. Jesse, on the other hand, rails against a fitness industry that is primarily “designed to get you laid as quick as possible” and that often results in injury.

Jesse looks at how you’re moving and assesses where your body has “lost” movement. For me, he immediately focused into how little mobility I had in my lower back, and hypothesized that my neck and shoulder pain were related to this lack of mobility. I was skeptical. But I had been focusing on my shoulder for a year with minimal results, so I decided to play along anyway and see where this went.

At first the movements seemed silly to me, and I told him a couple of times, “This does not really seem like a workout.” He explained, and then explained again, that we are starting with movement restoration, and once we get there, we’ll add in skill and conditioning. In spite of my impatience, I did the silly things, and in about a month I realized I HAD NO PAIN IN MY SHOULDER. What was even happening?! Beyond that, my balance had improved, I had less neck pain, and, oh, turns out I actually could do squats! I was sold on this “movement therapy” stuff.

One Year Later

Jesse and I have been working together for a year now. Today is our training-iversary. It sounds a bit melodramatic to say that Jesse has changed my life, but it’s true anyway.

I’m not thinner, exactly, but my body’s shape has changed. Not only have I NOT injured myself in the process, but I have far less pain, and tools to address any pain that I encounter. I do squats like a boss. I climb things on playgrounds with my 5-year-old. I know how to move after I’ve been typing for a while, and since I actually do the movements(!), I don’t get headaches and lose neck mobility during high-stress times. I cannot even believe how strong my legs are. I don’t look at stairs with dread, because stairs are no big deal now. I can do an hour of heated yoga and not die. This is what it is like to feel strong.

But the way that working with Jesse has bled into my life outside the gym is perhaps even more interesting. At this time last year, there were so many things (in working out and in all aspects of life) that I assumed I could not do, and wouldn’t even try. My inner critic was loudest in the gym, but she was seldom quiet anywhere. My fear of failure kept me on the sidelines more than I’d like to admit. Jesse and I have had sessions where the coaching has centered more around my mindset than my muscles, and I am a braver person for it. Over the course of this year, it has become very clear to me that I actually can do a lot of “scary” things, even when I am sure I can’t. Not everything comes easily, but it’s a process, and it turns out that’s actually fine. Normal, even. Just when I am certain that Jesse will give up on me and that I am clearly a giant disappointment, he pulls out his seldom-utilized stern voice and lectures me about self-care, and listening to my body, and being patient with myself.

So I’m a work-in-progress. And I’m actually really enjoying the progress, for once. I’m focusing on becoming strong to be helpful. And to be playful. Because I want my kiddo to remember me in the fray with him and not on the sidelines. He deserves that. And you know what? So do I.

KimberlyHeadshot_9.9.15Kimberly Culbertson is a Team Dynamics and Leadership Coach and Speaker, and she co-hosts the Creation Curve Leadership podcast. She is a recovering approval addict, a paint brush loving workaholic, and a walking billboard for hope in all its many manifestations. She is not afraid to admit that latte art lifts her spirits, and she gets a little melancholy when she doesn’t make it into a coffee shop for a few days.

Natural Movement Lifestyle

Natural Movement is a lifestyle

Jesse James Retherford coaching natural movementHow much do you think about your movement? Every movement you make or don’t make throughout the day is an opportunity to make a choice. What that movement or lack of movement looks like is a valuable opportunity. Why? Because Natural Movement is a lifestyle choice. Which has parallels into our physical as well as intellectual, emotional, and spiritual body. 

I like to think about movement the same as nutrition. How you move is how you feed your body movement. When you sit in front of a computer for eight hours per day, it is the equivalent of feeding your body McDonald’s. That one hour workout after work isn’t going to make up for eight hours of Micky D’s. 

Your body needs more throughout the day. It needs more macronutrients. It needs more micronutrients. You need to feed your body more kale! Your body needs little movement snacks fed to it throughout the day. As a MovNat coach not only do I teach natural human movement, I am also a consultant. I help my clients see where resistance exists and provide them with the tools to move past whatever is holding them back.

As a lifestyle, it’s not just about how you move during your hour long training session, but how you integrate movement practices throughout your day and life. It’s developing new habits of movement. To create new habits, change must happen, and with change comes resistance.

Through making better movement choices, developing new habits around movement, and overcoming resistance from change, my clients grow and evolve their movement lifestyle. They get to feel and experience growth in all aspects of their life, intellectually, emotionally, and spiritually.

This is where movement can facilitate life change.

Ready to begin your movement practice? Try going through these movements twice a day for the next week and share your progress with me on The Art of Fitness Facebook page.

Will going barefoot prevent injuries?

Will going barefoot cure injuries? going completely barefoot cure injuries?

As a Movement Therapist and Coach, I know that there are many many benefits to going completely barefoot. I’ve witnessed it with clients and have experienced it in my life. One of the most common questions I receive is will going completely barefoot cure injuries?

A slow healthy barefoot transition can help with many pain and injury complaints, but It will NOT however magically cure you of all your injuries. This idea is a falsehood that really needs to stop being spouted. It’s dangerous advice to follow and it’s just plain wrong.

In fact, transitioning into a barefoot lifestyle after many years in shoes has many inherent risks and can be equally if not more problematic. I see just as many, if not more, injuries from people transitioning to barefoot/minimalist as I do with those who are exclusively shod.

Will going barefoot cure injuries? encourage all of my clients to slowly explore a more and more barefoot experience. There is value to spending quality time exploring the world barefoot. I teach them to listen to what their body tells them through movement. And I don’t drive a hard line ideology that being barefoot is THE WAY. It is not for everyone. But everyone CAN gain benefit from spending at least a little time barefoot each day.

Looking for another great barefoot resource? Check out Katy Bowman’s blog and read her books. Or better yet, schedule a free consultation with me.

Jumping and Landing

Do you jump well?

Jumping and Landing

Woman doing box jump Jumping is a powerful exercise with many great benefits. However, your jumping is only as good as your ability to land efficiently.

Landing is the equivalent of the brakes on your car. It’s your ability to slow down or stop momentum. It is your body’s ability to absorb the energy of impact. The inability to land efficiently is a huge reason for pain and injury.
Landing is one of the most important movement skills that most people don’t do well. Something that makes landing doubly important is it is a part of the ONE movement you do more than any other… Walking/Running Gait mechanics.

If you don’t land well, then every step you take loads a poor movement pattern into your body. If you take the recommended 10,000 steps a day, eventually something is going to hurt.

Landing Phase of Gait
Jumping and Landing

With each footfall, impact energy should be absorbed throughout the kinetic chain of your body – i.e. joint by joint from your feet to head and back out through the opposite foot – like a loaded spring.

When this full body loaded spring isn’t functioning optimally due to injury, overtraining, or just lack of use, it is unable to absorb and unload energy efficiently. This creates energy leaks somewhere in the kinetic chain. Your body still has to slow down or stop momentum, so the load of impact is leaked out into the less absorptive areas of your structure – such as directly into the joints. This can create all kinds of secondary compensations and pain.

And because landing is a full body movement, the compensations and pain can be anywhere. Maybe that pain your neck is actually coming from the how your body interacts with the ground?

I put a huge focus of my program design on teaching and integrating the skill of efficient landing because it is so important for the prevention of pain and injury.

Learn to land well so that when you jump, the sky’s limit.

Sciatica Pain tips for Low Back Pain Relief

As a licensed massage therapist, I specialize in chronic pain and injury management using deep tissue massage therapy. Most of my clients come in with a common complaint: pain in the low back, hips (primarily on one side), and/or shooting pain or numbness down the back of the leg commonly referred to as sciatica pain. More than two million Americans suffer either from back pain or a form of sciatica that is often misdiagnosed and improperly treated.   Many suffer from pain for months or years without a proper diagnosis.  I work with these symptoms so frequently that I have noticed some common characteristics with this all-too-common pain complaint.

Pelvis with sciatic nerve and piriformis
Hip joint. Red: Piriformis muscle. Blue: Sciatic nerve.

The most common characteristics I find are aggravated myofascial trigger points (TrPs) in the piriformis muscle.  Piriformis trigger points are often confused for a herniated disc, sciatica, or other back issues, and many sufferers undergo unnecessary and costly tests, injections, and surgeries.

What is the piriformis?

The piriformis muscle is a small external rotator of the hip whose function primarily is to turn the knee and foot outward. It lies deep within the gluteal muscles, originates from the sacral spine, and attaches to the greater trochanter of the femur — the big bony “bump” on the outside top of the thigh.  The sciatic nerve passes beneath through an opening called the sciatic notch.


Hip abduction


In non-weight bearing activities, foot unloaded and hip extended, the piriformis rotates the thigh outward. When the hip is flexed at 90 degrees it aids in hip abduction. Hip Abduction. In weight-bearing activities, foot loaded, the piriformis is often needed to control the rapid medial rotation of the thigh — for example, as the foot strikes the ground during walking or running, the knee turns inward.
Trigger point referral pain pattern from sciatica nerve impingement due to piriformis
Piriformis trigger points and referral pain pattern


Piriformis Trigger Points Symptoms

The myofascial sciatica pain component includes pain in the low back, groin, buttock, and hip.  A trigger point may cause the muscle to compress and irritate the sciatic nerve, causing the pain to travel along the course of the nerve. The pain may radiate down the back of the leg and into the hamstrings, the calf muscles, and possibly the foot. The pain may initially be confused with a hamstring strain or diagnosed as true sciatica. Weakness, stiffness and a general restriction of movement are also quite common. Tingling, numbness, or shooting pains down the leg can also be experienced.  Symptoms tend to be aggravated by prolonged sitting or by intense activity.

Piriformis trigger points are predominantly caused by a shortening or tightening of the piriformis muscle.  Piriformis trigger points are commonly associated with sports that require a lot of running, change of direction, or weight-bearing activity.  Piriformis trigger points can result from acute overload (as when catching oneself from a fall), from repetitive overload (as with the rapid internal rotation of the weight bearing experienced by walkers and runners with poor biomechanics),  or from sustained overload (as when holding the leg bent and turned outward for prolonged periods while driving a car or working at a desk).  Sciatica pain from piriformis trigger points is also a common complaint during pregnancy.
Pic of inflamed sciatic nerve due to piriformis impingement
Impingement of sciatic nerve from piriformis TrP

The piriformis muscle is responsible for the symptoms of pain by projecting pain from activation of the trigger points and by nerve entrapment upon the sciatic nerve.  Once trigger points are activated, the piriformis muscle begins to put pressure on the sciatic nerve.  The sciatic nerve runs under (and sometimes through) the piriformis muscle on its way out of the pelvis. The piriformis muscle can squeeze and irritate the sciatic nerve in this area, leading to the symptoms of sciatica.

Treatment and Prevention

The first two steps in treating piriformis trigger points can provide the most significant and immediate relief: deep tissue massage with stretching of the external rotators of the hip.  Deep tissue massage techniques such as myofascial release and trigger point therapy are highly effective at reducing active trigger points. Once the trigger point is released, there will be a significant reduction in pain.

The Grid Foam Roller by Trigger Point Therapy

Following up the massage with flexibility training will help loosen the muscle and help prevent a return of the trigger point and sciatica.  I have found that it takes between four and ten massage sessions to move out of the acute pain phase from piriformis trigger points.  It may be shorter or longer depending on the cause and severity of the initial injury.

For long-term prevention of piriformis TrPs, self-myofascial release and flexibility will be your most invaluable tools.  Below are some pictures of how to relieve piriformis TrPs using a ball (preferably a tennis ball for beginners) and how to stretch the piriformis muscle and other external rotators of the hip.  With each stretch, it is important to breathe into the stretch and only stretch to slight discomfort … NOT PAIN.

Using a soft ball to release the piriformis muscle and gain relief from sciatic pain patterns.
Self-trigger point therapy using a ball. Find a painful spot in the glutes, relax your body into the ball, hold the position for 30-60 seconds or until you notice a significant reduction in pain. Move to the next painful spot. 5-10 minutes total.
Stretching the piriformis muscle in a supine figure four stretch.
Lying piriformis stretch. Place the leg you are stretching mid-calf on opposite knee. Pull opposite knee towards chest while at the same time pulling the knee of stretching leg towards opposite shoulder. Hold 30-60 seconds.
Seated gluteal stretch. Cross the leg being stretched over opposite leg. Wrap opposite elbow around the knee and pull towards opposite leg. Keep your back straight. Hold 30-60 seconds.
Seated gluteal stretch. Place ankle of the leg being stretched on opposite knee. Throw both hands over your leg, take a deep breath, and, as you exhale, allow your chest to drop toward the floor. Hold 30-60 seconds.
Modified pigeon pose. Place leg being stretched on a table, couch, or bed with knee bent and opposite leg resting on the floor. Drop your chest toward to table. Hold 30-60 seconds.

Other suggestions to prevent Piriformis TrPs

Get assessed by a qualified movement therapist. The exercises shown here are a guide to provide temporary relief. They are not a permanent fix. The underlying movement issues that are causing your piriformis to impinge your sciatica nerve need to be addressed. Find a highly skilled movement therapist in your area who can assess muscle function and gait mechanics.

Our bodies were designed to move.  It is important to keep moving.  Try not to sit down for more than an hour at a time. Stand up, take breaks, go for a walk, and move your body throughout the day. Lack of movement causes muscle dysfunction. Proper movement is key to an active healthy life. With an exercise program that focuses on functional movement patterns with core strength and stabilization, regular full body massage (self-massage or professional), and full body flexibility you will reduce your chances for chronic pain and injuries.


Change the way you walk and run. Heel strike is the most common dysfunction in running/walking gait. As soon as the heel strikes the ground, the knee rapidly moves into external rotation followed by rapid inward rotation. This places repetitive trauma on the piriformis muscle and leads to TrP formation and activation. I suggest hiring a coach who instructs forefoot or midfoot strike running form.

Replace your shoes. Modern running shoes promote heel strike. I advocate shoes with as little cushion and arch support as your body can handle.

Be smart with a shoe and form transition. Your body has adapted to how you walk and the shoes you wear.  A fast transition without proper instruction and training raises your risk of significant injury.  Below is a great article about what is wrong with your running/walking shoes.

What Happens to Our Foot When We Wear Traditional Running Shoes

This is the foam roller I recommend: The Grid by Trigger Point Therapy. This is an affiliate link. If you click it and make a purchase, The Art of Fitness will receive a small commission. These commissions help support TAO-Fit to continue producing life-changing content. Thank you for your support.

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